Latino men represent a quickly growing segment of the U.S.
population. As such, it is important to document the health of these
individuals. Data were collected from one of the largest gay networking
Web sites in the U.S. Using multivariate logistic regression
relationships between participant characteristics and sexual health
outcomes and behaviors were examined. The sample included 1,880 Latino
men self-identifying as gay (83.7%) and bisexual (16.3%). Findings
suggest the majority of men had not tested positive for any STD
(86.8-92.0%) or H1V (79.9%), however overall STD testing was low (33.9%)
compared to HIV testing (55.6%) during the previous year. Additionally,
education level, employment, sexual orientation, and relationship status
significantly influenced a variety of sexual behaviors and sexual health
outcomes.

Keywords: Latino men, HIV, sexual behavior, online research, men
who have sex with men (MSM)

**********

As the United States becomes increasingly diverse it is important
to understand the complexities of race and ethnicity in relation to
health outcomes and how these identities intersect with other
demographic characteristics such as educational attainment, age, and
location. Previous research has established that Latinos have become the
largest ethnic minority in the U.S., with one out of eight individuals
in the United States self-identifying as of Hispanic origin (Vidal de
Haymes & Kilty, 2007; U.S. Census Bureau, 2003) Additionally, the
most recent census data has shown that individuals identifying as
Hispanic or Latino made up 16.3% of the US population surpassing all
other racial and ethnic minority groups (U.S. Census Bureau, 2010).

Studies have examined various aspects of Latino men's sexual
lives including traditional gender and sexual norm socialization in
which men and women have differing experiences based upon cultural
beliefs surrounding the roles of men and women within Latino culture
(Raffaelli & Ontai, 2004). Most research to date has focused on
understanding Latino men's sexuality through a gendered lens
because of cultural beliefs surrounding manhood and sexual behavior
among this group, specifically exploring aspects related to machismo,
sexual risk taking and intimate partner violence (Asencio, 1999).

Fewer studies have investigated sexual behaviors among Latino gay
and bisexual men, with the majority focusing on sexual position taking
by Latino men based upon perceived masculinity of sexual partners
(Carballo-Di6guez, Dolezal, Nieves, Diaz, Decena, & Balan, 2004).
Jefferies (2007) found that Latino men, excluding Mexican men, had an
increased likelihood of having engaged in anal sex compared to
non-Latino men, as well as preferring the insertive role during oral sex
and during anal sex. Mexican men, in the same study, were more likely
than other self-identified Latino men to be the receptive partner during
anal sex. Several studies around sexual role position among Latino gay
and bisexual men have suggested that role segregation (i.e., insertive
or receptive role during sex) is highly prevalent among this group due
to cultural notions of active and passive roles (Carrier & Mangana,
1991; Munoz-Laboy, 2004) in the United States.

While these studies are an important first step into understanding
Latino gay and bisexual men, more investigation into the sexual lives of
this group is needed to present a clearer image of their sexual
behaviors. This study sought to document Latino gay and bisexual
men's sexual behaviors with other men and their associations with
health outcomes.

METHOD

Participants and Procedure

Participants resided in all 50 United States with the largest
percentages of men reporting their home state as Texas (n = 266, 14.1%),
California (n = 211, 11.2%), Florida (n = 169, 9.0%) and New York (n =
157, 8.4%). The states with the fewest participants included: Wyoming (n
= 1,0.1%) Kentucky (n = 1,0.1%), North Dakota (n = 2, 0.1%) and Vermont
(n = 2, 0.1%). The mean age of the sample was 33.29 (SD = 11.27), most
had attended at least some college (n = 1,310, 84.4%), and were employed
full-time (n = 1,125, 70.3%). The majority identified as homosexual/gay
(n = 1,310, 81.9%) with the remaining indicating they were bisexual (n =
306, 16.3%). Most men indicated they were not currently dating anyone (n
= 815, 50.9%), and were sexually active, but not in a sexual
relationship (n = 745, 46.6%). Participant characteristics are
summarized in Table 1.

The study was conducted in partnership with one of the largest
online social and sexual networking internet sites for men who have sex
with men. An electronic message was sent to all users of the website
briefly summarizing the study and its incentives, and providing a link
directing them to the study website. The recruitment message remained in
each individual's electronic mailbox for a period of 7 days, after
which time any unopened emails were automatically removed. A total of
127,489 individuals opened the recruitment email and 34.1% of these men
clicked on the link to the study website. Of those viewing the study
information and consent form, 60.4% consented to and subsequently
participated in the study. Data presented in this article are limited to
the 1,880 men who identified themselves as Latino and gay or bisexual.
All study protocols were reviewed and approved by Institutional Review
Board at the academic institution of the first author.

Measures

Sociodemographics. Measures included those related to a
participant's age, gender (male, female, transgender male to
female, transgender female to male), sexual orientation, race/ethnicity,
level of education completed, U.S. state of residence, and employment
status. Participants also responded to items related to relationship
status (married, partnered, divorced, widower, single, and other);
whether they were currently dating someone or in a relationship (in a
relationship with the same person longer than 6 months, 3-6 months, less
than 6 months, dating more than one person, or not dating anyone), and
whether they were currently in a sexual relationship (with one person,
more than one person, sexually active but don't consider myself in
a sexual relationship, or currently not sexually active).

Health status. Measures included those related to physical and
mental quality of life using the 4-item Healthy Days Core Module from
the CDC health-related quality of life measure (HRQOL-4) (CDC, 2000a), a
widely validated set of survey measures used to assess a person's
sense of well-being, during the past 30 days, through four items
(Ahluwalia, Holtzman, Mack, & Mokdad, 2003; Andresen, Catlin,
Wyrwich, & Jackson-Thompson, 2003; CDC, 1998, 2000b, 2001; Moriarty,
Zack, & Kobau, 2003). In addition, we assessed history of
participation in self- (genital and testicular self-exams) and
provider-administered (general physical exam) exams.

Sexual behaviors. Participants were asked to indicate whether or
not they had engaged in specific sexual behaviors with both women and
men within the past month, past three months, past year, more than a
year ago, or never. Behaviors included masturbation, receptive anal
intercourse, insertive anal intercourse, insertive vaginal intercourse,
performing oral sex, and receiving oral sex. For behaviors reported
within the past year, participants were asked to indicate how frequently
they had engaged in each. Response options included "a few times
per year," "about once per month," "a few times per
month," "about once per week," "2-3 times per
week," "almost every day," and "more than once per
day." Measures used were consistent with those used in a recent
nationally representative study of sexual behavior in the United States
(Herbenick, Reece, Schick, Sanders, Dodge & Fortenberry, 2010).
Additionally, to assess unprotected behaviors, participants were asked
to indicate the numbers of times they used a condom during the past ten
times they engaged in receptive anal intercourse, insertive anal
intercourse, and vaginal intercourse (Reece, Herbenick, Sanders, Schick,
Dodge, & Fortenberry, 2010).

Data Analysis

PASW version 19.0 (Chicago, IL, USA) was used to conduct all
analyses. Descriptive statistics were used to examine the participant
demographic characteristics, health status, and sexual behaviors. A
multivariate logistic regression model was used to test the relationship
between participant characteristics and health-related outcomes, sexual
health-related screenings, and sexual behaviors.

RESULTS

Health Status, Screening, and Diagnosis

Overall the sample was healthy with most participants
self-reporting their health to be "very good" (n = 775,43.2%),
"excellent" (n = 587, 32.7%), or "good" (n = 369,
20.6%). The mean number of days the participants reported physical and
mental health concerns was 5.07 (SD = 7.06), and 7.71 (SD = 7.52)
respectively, and reported on average, 5.90 (SD = 6.5) days of limited
activity due to illness which is well below the CDC (2003) guidelines
defining "good" health (under 14 days). Just over half of men
(50.1%) had performed a testicular self-exam and 68% (n = 1,278) had
visited a provider for a physical exam within the past year. Over half
of participants had received an HIV test within the past year (55.6%),
however screening for other STDs during that same time period was lower
with only 33.9% reporting having been tested. When asked to report
confirmed diagnosis of STD in the past two years the majority indicated
they had not tested positive for Syphilis (n = 1,389, 86.8%), Gonorrhea
(n = 1,664, 93.4%), Chlamydia (n = 1,681,94.4%), HPV (n = 1,675, 94.3%),
or Herpes (n = 1,635,92%) in the previous two years. HIV was the most
prevalent (n = 235, 14.7%) occurring sexually related illness among the
sample. Table 2 summarizes these findings.

Condom Use

Participants were asked to report the number of times they had used
a condom during the last ten occurrences of specific sexual behaviors.
On average men reported using condoms more often when they were the
receptive partner in anal intercourse ([bar.x] = 6.38, SD = 145) than
when they were the insertive partner in both anal intercourse with a
male partner ([bar.x] = 6.27, 1.45) and vaginal intercourse ([bar.x] =
5.6, SD = 1.58).

Sexual Behaviors

Participants were asked to indicate whether or not they had
participated in a range of sexual behaviors and to indicate the recency
and past year frequency of these behaviors. Table 4 provides a summary
of men's reports of participation in these behaviors within their
life time, and Table 5 provides a more detailed summary of the recency
of men's participation in these behaviors. Table 6 provides a
summary of the reported frequency of men's participation in these
sexual behaviors during the past year.

Solo and partnered masturbation. Masturbation alone was the most
common sexual activity among participants. The vast majority of men
stated they had masturbated alone (n = 1,753, 99.83%), with 97.2% (n =
1,707) indicating masturbation within the past month. Nearly all
participants (88.5%) reported engaging in solo masturbation at least
weekly, with the frequency of masturbation including more than once a
day (n = 246, 14.1%), almost daily (n = 673, 38.6%), two or three times
per week (n = 481,27.6%), and about once a week (n = 143, 8.2%).
Similarly, most men (95.6%) indicated they had masturbated with a
partner during their lifetime, with over a third (n = 70.6%) of
participants indicating they had done so within the past month.

Sexual activity with men. The majority of men (n = 1,737, 98.8%)
reported that they had inserted their penis into another man's
mouth during their lifetime with most men (n = 1,369, 77.9%) indicating
they had done this in the past month. The second most common behavior (n
= 1,714, 97.6%) over the lifetime was inserting another man's penis
into their mouth with most (n = 1,315, 74.8%) having done this in the
past month. Of those reporting having had inserted their penis into
another man's anus during their lifetime (n = 1,636, 94.3%) 52.6%
(n = 984) reported having done so within the past month. Of those
indicating they had inserted their penis into another man's anus
during the past year (n = 1,415), 31.4% reported having done this a few
times (n = 445) during this time period. Similar to the rates of
insertive anal intercourse 91.1% (n = 1,597) of men had engaged in
lifetime receptive intercourse, with 49.5% (n = 867) having done so in
the past month and most (n = 1,329, 75.8%) reporting participating in
this behavior a few times during the past year. Of those indicating
participant anal sex the majority of men (68.9%, n = 1,241) had been
both the insertive and receptive partner during anal sex in the past
year with half (50.4%, n = 620) having done this is the past 30 days.

Participant Characteristics and Health

Sexual orientation and relationship status were significant
predictors of STD testing and sexual orientation, employment status, and
age were significantly associated with HIV testing. Men who identified
as bisexual were more likely to have had an STD screening the past year
(OR = 1.34, CI = 1.04-1.74) compared to their gay identified
counterparts. Participants responding they were currently in a
relationship with more than one person were less likely (OR = 0.58, CI =
0.36-0.93) to have been screened for STI compared to those in a
relationship for more than five years with only one person. Men who
self-identified as bisexual (OR = 0.44, CI = 0.29-0.66) and unemployed
(OR = 0.51, CI = 0.27-0.98) were less likely to have been tested for HIV
during the past year. Finally, older men were more likely to have had an
HIV test during the past year compared to younger men (OR = 1.08, CI =
1.04-1.10).

Bisexual men were less likely to have been diagnosed with an STD or
HIV (OR = 0.44, CI = 0.29-0.66) during the past year. Predictors of
having been diagnosed with HIV included sexual orientation, age, and
employment status. Additionally, men who were older (OR = 1.08, CI =
1.06-1.10) and indicated they were unemployed (OR = 2.14, CI =
1.24-3.70) were more likely to have been diagnosed with HIV.

Participant Characteristics and Sexual Behavior

Sexual orientation and relationship status were significant
predictors of partnered masturbation. Men who identified as bisexual (OR
= 0.44, CI = 0.29-0.66) were less likely to have masturbated with a
sexual partner, while those who were single were more likely to have
masturbated with a sexual partner. In terms of oral sex, men who
indicated they were bisexual and currently unemployed were less likely
to receive (OR = 0.52, CI = 0.31-0.88; OR = 0.24, CI = 0.13-0.46,
respectively) or perform (OR = 0.44, CI = 0.282-0.685, OR = 0.48, CI =
0.24-0.94, respectively) oral sex on a male partner. Additionally,
participants indicating they were not currently in a relationship were
less likely to perform oral sex (OR = 0.40, CI = 0.20-0.78).

With regards to anal sex, those who were more likely to be the
insertive partner were in a relationship for one to five years (OR =
2.62, CI= 01.50-4.58) or six months to a year (OR = 3.90, CI =
1.16-13.13) with only one person. Men who indicated being in a
relationship for one to five years (OR = 1.64, CI = 0.29-0.66) or that
they were currently dating more than one person (OR = 1.93, CI =
1.03-3.61) were more likely to be the anal receptive partner.
Additionally, men with a professional level of education were less
likely (OR = 0.55, CI = 0.32-0.96) than those without a college level of
education to be the receptive partner.

DISCUSSION

Overall the sample was healthy, with most men reporting their
health to be good, a low number of STD diagnosis in the previous 2
years, and almost all men had been tested for HIV at some point during
their lives. Similar numbers of men indicated having had a STD and HIV
test during the past year, suggesting this group is conscious of their
sexual health needs with regards to testing behavior. However, almost
half (44.4%) had not been screened for HIV and nearly two-thirds (61.6%)
had not received an STD in the past year, highlighting that public
health messages regarding testing, especially for STDs, are perhaps not
effectively reaching this group in its entirety. While these data do
suggest that condoms were not always used during the past 10 sexual
experiences overall use was relatively high. Further, instances of
condom non-use may not be warranted, to some degree, if sexual activity
was occurring with a primary partner whose STD and HIV status was known,
hence minimizing the level of risk for disease transmission.

Bisexual men were less likely to have been diagnosed with an STD or
HIV during the previous two years and more likely to have been screened
for STDs during the past year compared to their gay counterparts. Why
bisexual men were more likely to be screened for STDs is beyond the
scope of this paper, but it may be related to sexual activity outside of
primary relationships and concern for primary partners. Further, this
may be an outcome of STDs being perceived as less harmful compared to
HIV by a group that has historically received messages about the
importance of HIV testing, but not necessarily receiving these same
messages about STD screening to the same degree.

Participants reported on average between 5.07-7.71 days in which
they had experienced decreased physical or mental health or decreased
activity as a result of poor health. Although this number is well below
the 14 day cut off by CDC for clinical depression, it remains higher
than the number of days found in similar men of Caucasian ethnicity
(Rosenberger, et. al, In Press). These findings suggest that perhaps
issues of being doubly stigmatized as both an ethnic and sexual minority
may have implications for the health status of this population. Further
research should continue explore the ways in which social issues
surrounding ethnic minority status influence the health status of gay
and bisexual men and what affect this has on sexual behaviors.

In terms of behavior, receiving or performing oral sex were both
influenced by sexual orientation and jobs status with bisexual men and
those unemployed and not looking for work being less likely to
participate in either behavior. Self-identified bisexual men were also
significantly less likely to report being the receptive partner during
anal sex. Both of these finding may be an outcome of decreased
interactions with potential male sexual partners for both groups.
However, the lack of significant findings concerning bisexual men as
insertive partners suggests that bisexual men may be perceived as more
masculine therefore more likely to take on the active role during anal
sex. As suggested by Carballo-Dieguez et al. (2004) men who perceived
themselves as less masculine than their sexual partners were more
inclined to take on a passive role. Additionally, men who were not in a
relationship were less likely than those in a relationship for more than
five years to be the receptive partner during anal intercourse. This
same group was not significantly less likely to be the insertive partner
during sex suggesting that those not currently in a relationship may
avoid taking the receptive role during anal intercourse as a protective
behavior against HIV, as this role may be perceived as higher risk
compared to being the insertive partner outside the context of a
relationship. Older men and those with a professional level of education
(i.e., Ph.D., M.D., J.D.) were less likely to be the receptive partner
during anal sex. Further, men who were unemployed and not looking for
work were less likely to be the insertive partner. These findings
suggest that social status may be influence sexual positioning with
individuals holding a higher status in a sexual interaction being the
insertive partner. Older, more educated, and employed men may be
perceived as being masculine, as suggested by Carballo-Dieguez et al.
(2004), compared to those who are younger, less educated and not
employed. Additionally, older men may be seen as having more sexual
experience influencing their ability to take an insertive role. Further,
younger men may have less opportunity to engage in sexual activity
influencing receptive behavior patterns, however this is unlikely
because of the lack of significant findings in terms of insertive
behaviors.

Unlike previous studies examining role position during sexual
activity this sample was highly versatile, suggesting that role
segregation may not be as important to this group and that sexual role
position as suggested by Carballo-Dieguez et al. (2004), may be an
outcome of context and perceptions concerning the identity of a sexual
partner. In other words, sexual role position may be influenced by
perceived partner characteristics such as masculinity. However, this
finding should be taken along with its limitations because we do not
know the extent of time this sample had been living in the US and we did
not inquire about perceptions of sexual partners.

Finally, these data should be considered in terms of limits
inherent in the study design. The sample was not representative of the
general population, despite its size, and participants were recruited
through a website that might appeal to people who are more sexually
conscious, however, challenges exist with establishing truly nationally
representative samples of gay and bisexual Latino men. Because the
sample was entirely internet-based, we acknowledge the potential for our
data to not be generalizable to all gay or bisexual Latino men in the
U.S., particularly those that are less educated or lack access to online
technology.

Conclusions

Findings suggest that social position (i.e., educational
attainment, employment, and age) self-identified sexual orientation, and
relationship status may influence whether or not Latino gay and bisexual
men participate in a variety of sexual behaviors. Further, as documented
in previous studies (Carballo-Dieguez et al., 2004), the high level of
versatility in this sample suggests that perception of a sexual partner
may influence sexual decision making. For example, Carballo-Dieguez et
al. found that perceived masculinity of a partner influenced whether men
would take a passive or active role. In other words, this research found
that men who perceived their partners to me more masculine then they
perceived themselves would be more likely to take on the passive role or
the active role if they perceived their partner to be less masculine.
This study extends this through suggesting that those with higher social
positions being more likely to take on active roles. Future studies need
to further examine this to understand power dynamics and sexual role
positioning between varying social positions of sexual partners to
understand the ways in which perceived social position (beyond
masculinity) influence sexual position taking. While cultural notions
surrounding insertive and receptive behaviors may still hold true (e.g.
the more masculine man takes the insertive role), participants in this
study reported diverse anal sex behaviors, with men engaging in anal
intercourse as both the insertive and receptive sexual partner.

Overall, STI and HIV for this sample were low compared to US
National Averages (CDC, 2010) however this maybe more of an outcome of
rates of testing compared to actual low diagnoses. While over half of
individuals had be tested for HIV there exists a disconnect between HIV
testing and STD testing. This may indicate that because of public
health's emphasis on HIV among gay and bisexual men the importance
of STD testing may not be as apparent to this group. Additionally, this
could indicate that individuals perceive HIV as more threatening to
their health and are therefore more likely to be tested or may only be
tested when symptoms of STDs are present. Whatever the case it is
important to understand why as a group more than half of individuals are
being tested for HIV within the past year, but far less are being tested
for STDs which could potential put them at risk for HIV infection.

Vidal de Haymes, M. & Kitly, K.M. (2007). Latino population
growth, characteristics, and settlement trends: Implications for social
work education in a dynamic political climate. Journal of Social Work
Education, 43(1), 101-116.

Table 1
Participant Characteristics
n %
Age (n = 1,861)
18-24 446 24.0
25-29 335 18.0
30-39 547 29.4
40-49 406 21.8
50-59 108 5.8
60+ 19 1.1
Relationship Status (n = 1,869)
Longer than five years with one person 260 16.3
One to five years with one person 228 14.3
Six months to a year with one person 51 3.2
Three to six months with one person 51 3.2
Less than three months with one person 55 3.4
Currently dating more than one person 133 8.3
No currently dating anyone 815 50.9
Sexual Orientation (n = 1880)
Homosexual 1574 83.7
Bisexual 306 16.3
Education (n = 1874)
Did not graduate highschool 24 1.3
High school graduate/ GED 265 14.1
Some college/Associate's 712 38
Bachelor's 551 29.4
Master's 205 10.9
Professional (i.e., MD, PhD) 102 5.4
Other 15 0.8
Employment Status (n = 1860)
Full-time (35+ hours/week) 1304 70.3
Part-time 249 12.9
Unemployed, looking for work 205 10.7
Unemployed, not looking for work 102 5.3
Table 2
Sexual Health Status (n = 1600)
n $
Performed testicular self-exam past year
No 729 45.6
Yes 801 50.1
No response 70 4.4
STD test in the past year
No 985 61.6
Yes 543 33.9
No response 72 4.5
Syphilis diagnosis past two years
No 1389 86.8
Yes 115 7.2
No response 96 6
Gonorrhea diagnosis past two years
No 1414 88.4
Yes 90 5.6
No response 96 6
Chlamydia diagnosis past two years
No 1432 89.2
Yes 72 4.5
No response 108 6.8
Herpes diagnosis past two years
No 1393 87.1
Yes 99 6.2
No response 108 6.8
Ever been tested for HIV
No 141 8.8
Yes, over a year ago 494 30.9
Yes, within the past year 889 55.6
No response 79 4.7
Ever been diagnosis with HIV
No 1279 79.9
Yes 235 14.7
No response 86 5.4
Table 3
Recency of Sexual Behaviors
n %
Masturbated alone (n = 1756)
Done in the past month 1707 97.2
Done in the past three months 29 1.7
Done in the past year 8 0.5
Done more than a year ago 9 0.5
Never done this 3 0.2
Masturbated with another person (n = 1752)
Done in the past month 1237 70.6
Done in the past three months 229 13.1
Done in the past year 121 6.9
Done more than a year ago 88 5
Never done this 77 4.4
Inserted penis into another man's anus (n = 1751)
Done in the past month 984 56.2
Done in the past three months 231 13.2
Done in the past year 200 11.4
Done more than a year ago 221 12.6
Never done this 115 6.6
Had penis inserted into anus (n = 1753)
Done in the past month 867 49.5
Done in the past three months 249 14.2
Done in the past year 225 12.8
Done more than a year ago 256 14.6
Never done this 156 8.9
Inserted penis into another man's mouth (n = 1758)
Done in the past month 1369 77.9
Done in the past three months 202 11.5
Done in the past year 95 5.4
Done more than a year ago 71 4
Never done this 21 1.2
Had another man's penis in my mouth (n = 1757)
Done in the past month 1315 74.8
Done in the past three months 206 11.7
Done in the past year 115 6.5
Done more than a year ago 78 4.4
Never done this 43 2.4
Inserted penis into a woman's vagina (n = 1705)
Done in the past month 96 5.1
Done in the past three months 27 1.4
Done in the past year 57 3
Done more than a year ago 503 29.5
Never done this 1022 59.9
Inserted penis into a woman's anus (n = 1691)
Done in the past month 31 1.8
Done in the past three months 10 0.6
Done in the past year 27 1.6
Done more than a year ago 218 12.9
Never done this 1405 83.1
Inserted penis into woman's mouth (n = 1703)
Done in the past month 79 4.6
Done in the past three months 32 1.9
Done in the past year 54 3.2
Done more than a year ago 473 27.8
Never done this 1065 62.5
Put mouth or tongue on a woman's vagina (n = 1700)
Done in the past month 71 4.2
Done in the past three months 28 1.6
Done in the past year 54 3.2
Done more than a year ago 402 23.6
Never done this 1145 67.4
Table 4
Frequency of Sexual Behaviors During the Past Year
A few times About once
per year a month
n % n %
Masturbated alone (1744) 43 2.5 33 1.9
Inserted penis into a man's anus (1415) 445 31.4 249 17.6
Inserted a penis into my anus (1329) 502 37.8 234 17.6
Inserted penis into a woman's vagina (168) 73 43.5 30 17.9
A few time About once
per week a week
n % n %
Masturbated alone (1744) 125 7.2 143 8.2
Inserted penis into a man's anus (1415) 363 25.7 163 11.5
Inserted a penis into my anus (1329) 306 23 129 9.7
Inserted penis into a woman's vagina (168) 27 16.1 16 9.5
2-3 times Almost
per week everyday
n % n %
Masturbated alone (1744) 481 27.6 673 38.6
Inserted penis into a man's anus (1415) 161 11.4 29 2
Inserted a penis into my anus (1329) 129 9.7 26 2
Inserted penis into a woman's vagina (168) 18 10.7 4 2.4
More than
once a day
n %
Masturbated alone (1744) 246 14.1
Inserted penis into a man's anus (1415) 5 0.3
Inserted a penis into my anus (1329) 3 0.2
Inserted penis into a woman's vagina (168) 0 0
Table 5
Odds Ratio of Sexual Health-Related Outcomes & Testing by
Participant Characteristics
STD diagnosis past 2 years
OR CI (95%)
Age 1.00 (0.92-1.01)
Sexual Orientation
Homosexual (Ref)
Bisexual 0.63 * (0.43-0.90)
Relationship Status
Longer than five years with one person
(Ref)
One to five years with one person 1.11 (0.69-1.78)
Six months to a year with one person 1.34 (0.64-2.78)
Three to six months with one person 1.33 (0.61-2.90)
Less than three months with one person 1.80 (0.90-3.59)
Currently dating more than one person 0.69 (0.38-1.28)
No currently dating anyone 1.11 (0.77-1.62)
Education
Less than college (ref)
Some college/Associate's 1.37 (0.93-2.01)
Bachelor's 1.40 (0.93-2.11)
Master's 1.25 (0.75-2.08)
Professional (i.e., MD, PhD) 1.13 (0.59-2.17)
Employment Status
Full-time (35+ hours/week) (ref)
Part-time 1.35 (0.95-1.93)
Unemployed, looking for work 1.43 (0.99-2.06)
Unemployed, not looking for work 0.84 (0.47-1.49)
Positive HIV Diagnosis
OR CI (95%)
Age 1.08 *** (1.06-1.09)
Sexual Orientation
Homosexual (Ref)
Bisexual 0.20 *** (0.12-0.36)
Relationship Status
Longer than five years with one person
(Ref)
One to five years with one person 1.07 (0.66-1.74)
Six months to a year with one person 0.74 (0.32-1.73)
Three to six months with one person 0.94 (0.38-2.32)
Less than three months with one person 0.60 (0.23-1.57)
Currently dating more than one person 1.00 (0.55-1.80)
No currently dating anyone 0.76 (0.52-1.11)
Education
Less than college (ref)
Some college/Associate's 0.91 (0.59-1.40)
Bachelor's 0.77 (0.49-1.21)
Master's 0.67 (0.39-1.17)
Professional (i.e., MD, PhD) 0.46 * (0.22-0.96)
Employment Status
Full-time (35+ hours/week) (ref)
Part-time 1.40 (0.91-2.17)
Unemployed, looking for work 1.48 (0.96-2.28)
Unemployed, not looking for work 2.14 ** (1.23-3.70)
STD test in the past year
OR CI (95%)
Age 0.99 (1.04-1.10)
Sexual Orientation
Homosexual (Ref)
Bisexual 1.34 * (1.04-1.74)
Relationship Status
Longer than five years with one person
(Ref)
One to five years with one person 0.75 (0.77-3.40)
Six months to a year with one person 0.57 (0.27-2.51)
Three to six months with one person 0.67 (0.52-9.46)
Less than three months with one person 1.02 (0.16-1.18)
Currently dating more than one person 0.58 ** (0.36-1.69)
No currently dating anyone 0.96 (0.43-1.28)
Education
Less than college (ref)
Some college/Associate's 0.84 (0.58-1.47)
Bachelor's 0.86 (0.66-1.77)
Master's 0.72 (0.64-2.65)
Professional (i.e., MD, PhD) 1.06 (0.39-2.12)
Employment Status
Full-time (35+ hours/week) (ref)
Part-time 0.99 (0.76-1.98)
Unemployed, looking for work 1.08 (0.48-1.32)
Unemployed, not looking for work 1.49 (0.27-0.99)
HIV test in the past year
OR CI (95%)
Age 1.08 *** (0.98-1.00)
Sexual Orientation
Homosexual (Ref)
Bisexual 0.44 *** (0.29-0.66)
Relationship Status
Longer than five years with one person
(Ref)
One to five years with one person 1.62 (0.51-1.10)
Six months to a year with one person 0.82 (0.29-1.12)
Three to six months with one person 2.22 (0.33-1.33)
Less than three months with one person 0.44 (0.56-1.85)
Currently dating more than one person 0.78 (0.36-0.92)
No currently dating anyone 0.74 (0.71-1.29)
Education
Less than college (ref)
Some college/Associate's 0.92 (0.62-1.12)
Bachelor's 1.08 (0.63-1.18)
Master's 1.30 (0.50-1.07)
Professional (i.e., MD, PhD) 0.90 (0.65-1.74)
Employment Status
Full-time (35+ hours/week) (ref)
Part-time 1.23 (0.73-1.34)
Unemployed, looking for work 0.80 (0.79-1.48)
Unemployed, not looking for work 0.51 ** (0.98-2.26)
* p[less than or equal to]0.05, ** p[less than or equal
to]0.01, *** p[less than or equal to]0.001
Table 6
Odds Ratio of Sexual Behaviors by Participant Characteristics
Mutual masturbation
OR CI (95%)
Age 0.98 (0.96-0.99)
Sexual Orientation
Homosexual (Ref)
Bisexual 0.40 *** (0.27-0.58)
Relationship Status
Longer than five years with one person
(Ref)
One to five years with one person 2.08 (0.89-4.86)
Six months to a year with one person 0.83 (0.27-2.59)
Three to six months with one person 1.05 (0.29-3.79)
Less than three months with one person 2.26 (0.50-10.1)
Currently dating more than one person 1.89 (0.69-5.20)
No currently dating anyone 0.54 * (0.32-0.90)
Education
Less than college (ref)
Some college/Associate's 0.60 (0.35-1.03)
Bachelor's 0.84 (0.47-1.50)
Master's 1.09 (0.52-2.29)
Professional (i.e., MD, PhD) 0.58 (0.26-1.33)
Employment Status
Full-time (35+ hours/week) (ref)
Part-time 0.76 (0.47-1.22)
Unemployed, looking for work 0.89 (0.52-1.51)
Unemployed, not looking for work 0.60 (0.31-1.16)
Anal insertive partner
OR CI (95%)
Age 1.00 (0.98-1.01)
Sexual Orientation
Homosexual (Ref)
Bisexual 0.74 (0.54-1.02)
Relationship Status
Longer than five years with one person
(Ref)
One to five years with one person 2.62 *** (1.50-4.58)
Six months to a year with one person 3.90 * (1.16-13.1)
Three to six months with one person 0.96 (0.44-2.08)
Less than three months with one person 1.77 (0.78-4.03)
Currently dating more than one person 1.62 (0.88-2.96)
No currently dating anyone 0.90 (0.63-1.29)
Education
Less than college (ref)
Some college/Associate's 0.90 (0.62-1.30)
Bachelor's 1.11 (0.74-1.65)
Master's 1.15 (0.69-1.92)
Professional (i.e., MD, PhD) 0.75 (0.41-1.38)
Employment Status
Full-time (35+ hours/week) (ref)
Part-time 1.11 (0.76-1.63)
Unemployed, looking for work 1.11 (0.74-1.67)
Unemployed, not looking for work 0.60 * (0.37-0.98)
Anal receptive partner
OR CI (95%)
Age 0.97 *** (0.96-0.99)
Sexual Orientation
Homosexual (Ref)
Bisexual 0.46 *** (0.34-0.61)
Relationship Status
Longer than five years with one person
(Ref)
One to five years with one person 1.64 * (1.00-2.70)
Six months to a year with one person 0.66 (0.32-1.37)
Three to six months with one person 0.81 (0.38-1.73)
Less than three months with one person 1.57 (0.69-3.59)
Currently dating more than one person 1.93 * (1.03-3.61)
No currently dating anyone 0.66 * (0.46-0.93)
Education
Less than college (ref)
Some college/Associate's 1.11 (0.77-1.59)
Bachelor's 0.93 (0.64-1.35)
Master's 0.92 (0.58-1.46)
Professional (i.e., MD, PhD) 0.55 * (0.32-0.96)
Employment Status
Full-time (35+ hours/week) (ref)
Part-time 1.07 (0.74-1.55)
Unemployed, looking for work 0.93 (0.64-1.34)
Unemployed, not looking for work 0.92 (0.55-1.54)
Received oral sex
OR CI (95%)
Age 0.98 (0.96-1.00)
Sexual Orientation
Homosexual (Ref)
Bisexual 0.52 * (0.31-0.88)
Relationship Status
Longer than five years with one person
(Ref)
One to five years with one person 4.50 (0.97-20.8)
Six months to a year with one person (1) (1)
Three to six months with one person 0.90 (0.19-4.31)
Less than three months with one person 3.01 (0.37-24.6)
Currently dating more than one person (2) (2)
No currently dating anyone 0.49 (0.25-0.96)
Education
Less than college (ref)
Some college/Associate's 0.98 (0.52-1.85)
Bachelor's 1.20 (0.60-2.38)
Master's 1.66 (0.64-4.31)
Professional (i.e., MD, PhD) 0.99 (0.33-2.98)
Employment Status
Full-time (35+ hours/week) (ref)
Part-time 1.10 (0.54-2.26)
Unemployed, looking for work 1.05 (0.50-2.20)
Unemployed, not looking for work 0.24 *** (0.13-0.46)
Performed oral sex
OR CI (95%)
Age 0.98 (0.97-1.00)
Sexual Orientation
Homosexual (Ref)
Bisexual 0.44 *** (0.28-0.69)
Relationship Status
Longer than five years with one person
(Ref)
One to five years with one person 0.84 (0.35-2.05)
Six months to a year with one person 0.56 (0.15-2.14)
Three to six months with one person 0.63 (0.17-2.42)
Less than three months with one person 2.67 (0.33-21.6)
Currently dating more than one person 4.97 (0.63-39.2)
No currently dating anyone 0.40 * (0.20-0.78)
Education
Less than college (ref)
Some college/Associate's 1.34 (0.93-2.75)
Bachelor's 1.41 (0.77-2.36)
Master's 1.38 (0.68-2.94)
Professional (i.e., MD, PhD) 0.48 (0.52-3.65)
Employment Status
Full-time (35+ hours/week) (ref)
Part-time 1.47 (0.75-2.88)
Unemployed, looking for work 1.00 (0.54-1.84)
Unemployed, not looking for work 0.48 * (0.24-0.94)
* p[less than or equal to]0.05, ** p[less than or equal to]0.01,
*** p[less than or equal to]0.001
(1) Confidence intervals were omitted because no respondents
indicated being in a relationship for six months to a year and
not receiving oral sex.
(2) Confidence intervals were omitted because no respondents
indicated they were currently dating more than one person and not
receiving oral sex.